Cargando…

A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome

Antisynthetase syndrome is an autoimmune condition that manifests clinically through signs and symptoms, such as interstitial lung disease, myositis, Raynaud’s phenomenon, fever, hyperkeratotic fingertips (mechanic’s hands), and arthritis. It is associated with antibodies against aminoacyl tRNA synt...

Descripción completa

Detalles Bibliográficos
Autores principales: Khan, Aadil M, Ahmad, Faim, Rehman, Usama, Jindal, Himanshu, Harimohan, Hridya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883527/
https://www.ncbi.nlm.nih.gov/pubmed/33614339
http://dx.doi.org/10.7759/cureus.12737
_version_ 1783651226843348992
author Khan, Aadil M
Ahmad, Faim
Rehman, Usama
Jindal, Himanshu
Harimohan, Hridya
author_facet Khan, Aadil M
Ahmad, Faim
Rehman, Usama
Jindal, Himanshu
Harimohan, Hridya
author_sort Khan, Aadil M
collection PubMed
description Antisynthetase syndrome is an autoimmune condition that manifests clinically through signs and symptoms, such as interstitial lung disease, myositis, Raynaud’s phenomenon, fever, hyperkeratotic fingertips (mechanic’s hands), and arthritis. It is associated with antibodies against aminoacyl tRNA synthetase enzyme, the most common autoantibody being the anti-Jo-1. An 18-year-old girl presented with weakness of both the upper and lower limb, swelling and generalized body pain, difficulty in swallowing. MRI of the thigh was highly suggestive of myositis with symmetrical bilateral involvement. Based on proximal muscle weakness, elevated creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), strongly positive anti-nuclear antibodies human epithelial cell type-2 (ANA-HEp2), and a normal nerve conduction velocity test with precise MRI findings, a diagnosis of polymyositis was made. She was given bolus intravenous methylprednisolone for five days, followed by oral methylprednisolone with subcutaneous methotrexate weekly. She reported a 50% improvement in muscle weakness; however, partial bulbar weakness persisted at the time of discharge. On her next follow-up, her blood investigations for auto-antibodies were done. The autoantibodies anti-Jo-1 (3+), Ro-52 (2+), and Mi-2β (2+) were found to be positive. These investigations, coupled with the clinical features she was presenting, finally led us to conclude that it was a case of polymyositis complicated by the antisynthetase syndrome.
format Online
Article
Text
id pubmed-7883527
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-78835272021-02-18 A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome Khan, Aadil M Ahmad, Faim Rehman, Usama Jindal, Himanshu Harimohan, Hridya Cureus Internal Medicine Antisynthetase syndrome is an autoimmune condition that manifests clinically through signs and symptoms, such as interstitial lung disease, myositis, Raynaud’s phenomenon, fever, hyperkeratotic fingertips (mechanic’s hands), and arthritis. It is associated with antibodies against aminoacyl tRNA synthetase enzyme, the most common autoantibody being the anti-Jo-1. An 18-year-old girl presented with weakness of both the upper and lower limb, swelling and generalized body pain, difficulty in swallowing. MRI of the thigh was highly suggestive of myositis with symmetrical bilateral involvement. Based on proximal muscle weakness, elevated creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), strongly positive anti-nuclear antibodies human epithelial cell type-2 (ANA-HEp2), and a normal nerve conduction velocity test with precise MRI findings, a diagnosis of polymyositis was made. She was given bolus intravenous methylprednisolone for five days, followed by oral methylprednisolone with subcutaneous methotrexate weekly. She reported a 50% improvement in muscle weakness; however, partial bulbar weakness persisted at the time of discharge. On her next follow-up, her blood investigations for auto-antibodies were done. The autoantibodies anti-Jo-1 (3+), Ro-52 (2+), and Mi-2β (2+) were found to be positive. These investigations, coupled with the clinical features she was presenting, finally led us to conclude that it was a case of polymyositis complicated by the antisynthetase syndrome. Cureus 2021-01-16 /pmc/articles/PMC7883527/ /pubmed/33614339 http://dx.doi.org/10.7759/cureus.12737 Text en Copyright © 2021, Khan et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Khan, Aadil M
Ahmad, Faim
Rehman, Usama
Jindal, Himanshu
Harimohan, Hridya
A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title_full A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title_fullStr A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title_full_unstemmed A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title_short A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome
title_sort clinical case of polymyositis complicated by antisynthetase syndrome
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883527/
https://www.ncbi.nlm.nih.gov/pubmed/33614339
http://dx.doi.org/10.7759/cureus.12737
work_keys_str_mv AT khanaadilm aclinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT ahmadfaim aclinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT rehmanusama aclinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT jindalhimanshu aclinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT harimohanhridya aclinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT khanaadilm clinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT ahmadfaim clinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT rehmanusama clinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT jindalhimanshu clinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome
AT harimohanhridya clinicalcaseofpolymyositiscomplicatedbyantisynthetasesyndrome